2013," says Kris Sabo, RN, ADN, executive director and administrator
at Pend Oreille Surgery Center in Ponderay, Idaho.
The economic realities of modern-day health care have added
another service that providers must manage for their patients. "I was
always a patient advocate, now I've become their financial advocate,"
says Linda Winkelman, RN, director of the OR and outpatient services
at Community Medical Center in Falls City, Neb. "Insurance compa-
nies are becoming increasingly stringent with their approval of proce-
dures, as is Medicare. Trying to stay abreast of all these changes is
time-consuming and stressful."
Then there's the ever-expanding burden of regulations — and regulato-
ry compliance — to be tracked and reported, including infection preven-
tion, risk management and quality improvement. "Facility management
must be familiar with a vast amount of federal, state and regulatory
requirements," says Caroline Ivanovski-Hauser, CASC, administrator of
the Bergen-Passaic Cataract Surgery and Laser Center in Fair Lawn, N.J.
Such data-driven tasks may be essential to patient care, but they
don't constitute caring for patients. "It is more and more apparent that
the ASC manager must spend less time in the clinical setting and
more time managing the regulatory compliance of the facility and
staff," says a Kansas ASC director. While quality metrics ensure ASCs
operate at the top of their game, "balancing these 2 responsibilities
can be frustrating at best."
In other words, another respondent laments, "I have 35 binders in
my office I keep adding requirement documentation to."
Compensation consternation
Although the majority of hospital and ASC respondents received raises
over the past year, the percentage who reported being "generally satis-
fied" with their compensation was noticeably smaller. Considered as a
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